HomeMy WebLinkAboutInsurance Certificate: Premier West Bank
City County Insurance Services CERTIFICATE OF COVERAGE Rev. 717/€35
Agent This certificate is issued as a matter of information only and confers no rights upon the
DIRECT certificate holder other than those provided in the coverage document. This certificate
does not amend, extend or alter the coverage afforded by the coverage documents listed
herein.
Companies Affording Coverage
Named Member or Participant COMPANY A - City County Insurance Services (CIS)
City of Ashland COMPANY B - National Union Fire Insurance Company of Pitts, PA
20 East Main Street COMPANY C - RSUI Indemnity
Ashland, OR 97520
COVERAGES
This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement, term
or
condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is
subject
to all the terms, conditions and exclusions of such coverage documents.
CO Type of Coverage Certificate # Effective Expiration Limits
LT Date Date
A General Liability 10LASH 7/1/2010 7/1/2011 General Aggregate $15,000,000
X Commercial General Liability Each Occurrence $5,000,000
X Public Officials Liability
X Employment Practices
X Occurrence
A Auto Liability 10LASH 7/1/2010 7/1/2011 General Aggregate None
X Scheduled Autos Each Occurrence $5,000,000
X Hired Autos
X Non-Owned Autos
A Auto Physical Damage 10APDASH 7/1/2010 7/1/2011
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
A X Property 10PASH 7/1/2010 7/1/2011 Per Filed Values
A X Boiler and Machinery 10BASH 7/1/2010 7/1/2011 Per Filed Values
B X Excess Crime 10CASH 7/1/2010 7/1/2011 Per Loss $250,000
C Excess Earthquake
C Excess Flood
A Workers' Compensation
Description: For use of surface parking spaces in the vacant land as described in the month-to-month lease agreement dated
October 1, 2010, between Premier West Bank (Lessor) and the City of Ashland (Lessee). This property was previously owned by
Northlight LLC.
Certificate Holder CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date
thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to mail
Premier West Bank such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the
Special Assets Officer issuer of this certificate.
503 Airport Road, Suite 101
Medford, OR 97504
By: /7,4,ol.Date: October 20, 2010